Care Home: Merrifield House

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What the care home does well What has improved since the last inspection? First Key Inspection CARE HOMES FOR OLDER PEOPLE Merrifield House 90 High Street Wootton Northampton NN4 6JR Lead Inspector Helen Abel Unannounced Inspection 22nd January 2008 09.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merrifield House Address 90 High Street Wootton Northampton NN4 6JR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01604 705654 01604 705654 Krisoob317@aol.com Merrycare Limited Mr Radha Krishna Sooben Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (20) Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No one falling within category OP may be admitted to Merrifield House, Merrycare Limited where there are 20 persons within the category of OP already accommodated No one falling within category DE(E) may be admitted to Merrifield House, Merrycare Limited where there are 20 persons within the category of DE(E) already accommodated No one falling within the category MD(E) - excluding learning disability or dementia may be admitted to Merrifield House, Merrycare Limited when there are 6 persons within the category of MD(E) already accommodated. The maximum number of service users that can be accommodated at Merrifield House is: 20 First key Inspection 4. Date of last inspection Brief Description of the Service: Merrifield House is situated in the village of Wootton in Northampton. It is set over two floors with an extensive back garden with mature trees and border plants, and outdoor seating. It is accessible to shops and places of worship. The home offers services for 20 people above the age of 65 in the following category- dementia, and old age and up to 6 of the older people have may have a mental disorder. Additional charges are made for hairdressing, chiropody, personal magazines and newspapers, and opticians. Information about the home including the current inspection report is displayed in the reception area. Fees per week range from £348- 490. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspected the home against the Care Standards Act 2000. The inspection method used was ‘Inspecting For Better Lives’, which is based on outcomes for the residents. Planning for the inspection included reading the notifications of significant events sent to the CSCI and the Annual Quality Assurance Assessments (AQAA), which provides information as to the services, the home provides. Seventeen comment cards were returned directly to the CSCI from residents their relatives and supporters, and staff. Many of their comments are included in this report. The visit took place on Tuesday morning at 9.00 am and lasted over five hours. The registered manager assisted the Inspector during the visit. The method called ‘case tracking’ was used to determine the standard of care provided in the home surroundings. This involved identifying residents with varying levels of care needs and looking at how these are being met by the staff at Merrifield House. The Inspector had discussions with 5 residents and 3 staff. Discussions were held with staff providing the care, checking records relating to their health and welfare, viewing their personal accommodation as well as communal living areas used. Observations were made of how the care staff supported residents participate in the daily activities and decision-making. Records relating to care plans, medication records, health and safety, staff records, and training records were checked. What the service does well: Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 6 Good clear written information is provided to residents about services provided; and comprehensive assessment procedures ensure that residents needs and aspirations can be effectively met. Residents are well supported to take reasonable risks and excellent care plans accurately reflect their needs. A resident needing extra support care plan was being reviewed almost daily to reflect her changing need whilst including her views and wishes. Residents are weighed regularly and nutritional screening undertaken. This ensures residents nutritional needs are recorded and maintained and any appropriate action taken. Residents have excellent opportunities to engage in wide ranging social and recreational activities and enjoy varied nutritious food. Residents concerns are listened to and acted upon and good systems are in place to protect them. There are regular residents meetings where all issues are discussed and the residents make decisions around trips, events in the home, décor, and meal choices. Residents live in a clean, comfortable and homely environment, which meets their needs well. Bedrooms were personalized to residents liking and all have en-suite facilities, call points and smoke detectors, and are central heated and double-glazed. The lounge has been recently been opened up and refurbished to the resident groups wishes. Residents are effectively supported and protected by well-trained staff and thorough recruitment practices. Comments received from residents and relatives were, “The staff always appear very caring and sociable. They try to have different activities to keep residents occupied.” “I find the staff and Kris (registered manager) are wonderful with my mum and other residents.” Sound health and safety practices ensure resident’s welfare is promoted; whilst residents benefit from excellent leadership and the positive approach from the registered manager. Staff confirmed that they receive relevant training in safe working practices such as health & safety, fire, first aid, moving and handling, infection control. Other training has been dementia awareness, adult abuse, and National Vocational Qualifications (NVQ’s). Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good clear written information is provided to residents about services provided; and comprehensive assessment procedures ensure that residents needs and aspirations can be effectively met. EVIDENCE: The home’s statement of purpose and current inspection report is displayed in reception at the home. The statement of purpose is provided to all new residents who enter the home and sets out the aims and objectives, the range of facilities and services it offers to residents. A new residents family were given a copy of these documents and were reported to particularly welcome this information. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 10 A very comprehensive assessment process takes place before a new resident moves into the home. This includes the registered manager visiting the person in their current setting and meeting their family and supporters, collecting assessments from all professionals currently involved and arranging time for the person to visit the home to see how they fit in with the resident group. A full assessment written by the registered manager was in place covering all aspects of care, physical, mental and emotional health and social and cultural needs. The registered manager agreed to ensure the- This is Your Life information about the individual is presented as part of the assessment process. This will ensure this key information about a resident’s life is included when drawing up the care plan. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 10, 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well supported to take reasonable risks and excellent care plans accurately reflect their needs. EVIDENCE: Two residents care plans were examined. Like the assessment documentation were very detailed covering all aspects of daily life. Care plans were well written. Staff are fully aware of and actively contribute to care plans to gain information as to how to support and respond to individual residents. Care plans are regularly reviewed and modified to reflect residents changing needs and the necessary staff responses. The registered manager confirmed new residents are involved in every aspect of compiling their care plan. The Inspector reminded the registered manager to ensure residents or their supporters sign their care plan. Detailed daily notes are kept and reflect how Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 12 each resident has spent their day. Residents are weighed regularly and nutritional screening undertaken. This ensures residents nutritional needs are recorded and maintained and any appropriate action taken. A resident needing extra support care plans was being reviewed almost daily to reflect her changing need whilst including her views and wishes. The Commission received a letter for Social Care (CSCI) Inspection from a relative of an ex- resident to confirm the high standard of care received. “I wish to let you know that the care, gentle kindness and attention she received from Kris and his staff during her 2 year stay could not be faulted. Every time I visited Merrifield the residents looked happy and well cared for; they were often singing to music or playing games; the staff were welcoming and cheerful. I cannot praise Kris enough.” Some residents have their own mobile phones or telephones to use in private in their bedrooms as specified in their care plans. Staff were observed always speaking politely and respectfully to residents throughout the inspection. Systems for storing, recoding and administering medication are good. All staff receives accredited medication training. Photographs of residents are held on medication records for easy identification. The registered manager is in the process of producing a specimen signatures list for added clarity for the safe administration of medication; and developing a risk assessment for one medicine self administered by a resident. One medicine had been administered but not signed for by staff, the registered manager has requested clearer medication sheets as some of the times, for medicines to be given are obscured by print. The home has a has a good relationship with the Pharmacist and has regular medication audits. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents have excellent opportunities to engage in wide ranging social and recreational activities and enjoy varied nutritious food. EVIDENCE: Careful consideration is given to residents undertaking a wide range of social and recreational activities. On the morning of inspection the Inspector spent significant time in the lounge observing events. During this time residents were seen watching morning television, playing indoor golf, reading stories and playing matching cards. Residents were observed reading newspapers, and walking freely around the home. The Inspector suggested the use of the television is reviewed to allow for quieter periods. It was agreed the residents at their next residents meeting should discuss this. After lunch some residents went outside to get some fresh air accompanied by staff. Residents were seen coming and going with friends and relatives ensuring residents have some choice and control over their lives. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 14 A visitor told the Inspector, “Nice meals here. Every summer we have a barbecue outside, ex-relatives are invited to come. Kris (the registered manager) takes residents out shopping with him regularly. Residents are invited for cream teas at neighbour’s houses and he walks down to take them. When decorating the lounge recently Kris brought lots of samples of wallpaper and the resident group and relatives sat together and chose the wallpaper.” The agreed products were eventually used to decorate the communal lounge. Other activities provided are jigsaws, and some residents help with simple tasks peeling potatoes, and dusting. Very regular entertainment is arranged with an art person who comes in to make cards and calendars, a man who sings and plays his guitar, the flossy lady that dresses up in different outfits. There is a church service once a month at the home with guitar and prayers. When booking outside entertainment the registered manager confirms checking with the residents when they want the entertainer to come next and plan this out. They’re around 3-4 activities a day. Sometimes residents have complained there is too much entertainment and then this has been reviewed. In the lounge was a cycling machine that two residents use independently. The registered manager in consultation with the residents had purchased this. Three residents had travelled to a sports shop with the registered manager to choose the one they felt was right. Breakfast is served depending on individual need. Each resident’s specific likes and dislikes around breakfast are recorded on breakfast cards and reflect the care practise. When speaking to staff they confirmed individual’s time of rising and expectation for breakfast. One resident told the Inspector, “ Today I had, cornflakes, toast and butter and marmalade and a cup of tea, at 6’oclock, they know when I rise.” During lunch the dining room was attractively displayed with tablecloths, and condiments. A three-course meal was served with homemade soup, a chicken dish followed by trifle. It was noted some residents were explained the menu and asked to choose prior to lunch, but this didn’t apply to all the residents. It is important to offer residents choice on the menu so as they are able to make real choices and their capacity taken into account. The menu was displayed in the reception area but needs updating to reflect breakfast choices. The Inspector joined the residents for soup the first course, and talked to residents. Residents said, “The meals are good there is a lot to eat.” Staff confirmed sometimes residents have sherry or other alcoholic drinks (in moderation). Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents concerns are listened to and acted upon and good systems are in place to protect them. EVIDENCE: A formal complaints procedure is in place and written records are kept of any concern raised and the response made by the home. Residents told the Inspector, “ Kris (registered manager) is a darling, caring man whatever we need he will do. There are good girls (staff) here.” “ If something is wrong I would tell Kris” Residents were seen seeking out the registered manager and talking with him. There are regular residents meetings where all issues are discussed and the residents make decisions around trips, events in the home, décor, and meal choices. Staffs has received training in the protection of vulnerable adults and were aware of their responsibilities in reporting concerns. At staff Induction staff are made aware of all key policies relating to protection including whistle-blowing policy. Good recruitment practices including obtaining Criminal Record Bureau Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 16 checks before staff start work also contribute to good outcomes for residents in terms of protection. Resident’s rights are clearly outlined in the homes statement of purpose and displayed in the reception area. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and homely environment, which meets their needs well. EVIDENCE: The home is well maintained and is currently going through some decorating in some of the resident’s bedrooms. The lounge has been recently been opened up and refurbished to the resident groups wishes. The registered manager confirmed more building work would be done outside the back garden to provide a concrete patio area outside for residents to sit out on. This was decided after consultation with the residents and their relatives Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 18 Bedrooms were personalized to residents liking and all have en-suite facilities, call points and smoke detectors, and are central heated and double-glazed. There are three-day rooms, comprises of one lounge, a dinning room and a conservatory. A piano belonging to a resident is in the lounge and is sometimes played. The homes cat wandered around the lounge and was greatly favoured by the residents. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are effectively supported and protected by well-trained staff and thorough recruitment practices. EVIDENCE: All staff complete a comprehensive induction of 12 weeks, closely supervised by the registered manager a qualified Registered Mental Health Nurse. 18 staff are employed including full time and part time. The majority of staff have completed a BTEC training in medication management. Five members of staff have achieved their NVQ level 2. One staff member was successful at NVQ level 3. The deputy manager is completing a NVQ 4 (National Vocational Qualification Manager’s Award). One of the part time staff is undertaking the ‘Joint & Combined Honours, Health Studies & Social Welfare and another one is doing a post graduate in ‘Actuarial Science’. The aim of Merrifield House is to have above 50 of our staff with an NVQ Qualification or above. One staff member said they felt the training opportunities were good and that the training had helped them in their work. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 20 A wide range of comments were received from residents and relatives Commission for Social Care Inspection (CSCI) Comments Cards as follows: “All staff are very good. I am perfectly satisfied with it” “I find the staff and Kris are wonderful with my mum and other residents” “The care home supports my mother and the other residents with compassion. They are all friendly and provide a pleasant home for everyone. The home is well run, clean. It is homely with entertainment provided regularly” “I am very happy with the care my sister gets. The home always makes me feel welcome when I visit daily. They take my sister out every afternoon which is very much appreciated and so does my sister” “ The care home does its best.” “ The staff always appear very caring and sociable. They try to have different activities to keep residents occupied.” “ My cousin says how good the meals are and how kind and helpful the proprietor, and his staff are. I am able to see the proprietor on most occasions when I visit and can phone him to discuss her care. It is a small care home, well staffed and run. There is attention to detail and a friendly atmosphere in attractive and comfortable surroundings. ” Staff are deployed well with an additional staff member on duty between 8.45 to 10.00pm. The registered manager works in the home on a daily basis, supported by the deputy manager. Three staff recruitment records were examined and contained all the required checks to be made before employees start. The registered manager has introduced new recruitment systems and confirmed making rigorous checks toe ensure residents are protected. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,35, 36, 37, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Sound health and safety practices ensure resident’s welfare in these areas are promoted; whilst residents benefit from excellent leadership and the positive approach from the registered manager. EVIDENCE: The registered manager is a registered mental health nurse and has a wide range of experience in mental health. He uses his knowledge and experience to support the care provided and makes appropriate referrals to the community health care services. He is supported by a deputy and is looking to focus on training and development for his staff group as a priority for this year. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 22 Staff confirmed that they receive relevant training in safe working practices such as health & safety, fire, first aid, moving and handling, infection control. Other training has been dementia awareness, adult abuse, and National Vocational Qualifications (NVQ’s) Staff confirmed they receive regular support with supervision, staff meetings and the daily support from the registered manager. Commission for Social Care (CSCI) Comment Cards from staff confirmed: “ I am very happy to work in Merrifields House. Resident’s opinion is always considered in the first place. Staff are well trained and committed to their work. Merrifields is a lovely environment for residents and staff. ” Where residents are not able to manage their money a small amount is held on their behalf to pay for items such as hairdressers, chiropody, and newspapers. All records checked were generally in good order. An external person undertook an audit the day before the CSCI inspection. An action plan had been drawn up, with some of the issues raised by the Inspector captured in this audit. The registered manager confirmed openness into looking at ways to improve and develop the service. The registered manager is aware of his responsibilities in relation to health and safety, with confirmation of all necessary maintenance and safety checks are carried out. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 x x 3 3 3 3 Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/a STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations For staff to explain the choices from the daily menu so as each resident can make their own choice, and their capacity taken into account. Update the menu chart displayed to include breakfast choices on offer. Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Merrifield House DS0000068100.V357640.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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